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1. MRCGP Examination Answer Structures
& Grids
2. Consultation Models Pendleton
Neighbour
Byrne & Long
Stott & Davis
3. Pendleton 7 Tasks 1 Define reason for attendance (patients ideas/concerns/expectations)
Consider other problems
Choose appropriate action for each problem
Achieve shared understanding
Involve patient/accept responsibility
Use time/resources appropriately
Establish/maintain relationship with patient
4. Neighbour: 5 Checkpoints2 Connecting
Summarising
Handing Over
Safety Netting
Housekeeping
5. Byrne & Long3 Doctor Patient Relationship
Discover reason for attendance
Verbal/Physical Examination
Doctor/Patient consider condition
Doctor/Patient consider Treatment/Investigation
Terminate consultation
6. Stott & Davis4
7. Problem-Oriented Medical Records SOAP
Subjective
Objective
Assessment
Plan Pseudo-Latin
Hx (History)
Sx (Symptoms)
Ix(Investigation)
Mx (Management)
Rx (Prescribe)
8. 5 Areas of General Practice Clinical Practice Health & Disease
Clinical Practice Human Development
Clinical Practice Human Behaviour
Medicine & Society
The Practice
9. Health & Disease Normal Range
Patterns of Illness
Natural History
Prevention
Early Diagnosis
Diagnostic skills/techniques
Management/Treatment
10. Human Development Genetics
Foetal Development
Childhood Development
Physical
Intellectual
Emotional
Normal Range
11. Human Behaviour Behaviour presenting to Doctor
Behaviour in Relationships
Behaviour in Family
Behaviour in Doctor-Patient Relationship
12. Medicine & Society Sociological aspects
Uses of Epidemiology
Organisation of Healthcare in UK
comparison with abroad
recent changes
Relationship between Healthcare services and other institutions of society
13. The Practice Practice Management
The PHC Team
Finance
Premises & Equipment
Medical Records
Medico legal issues
Research
Lifelong Learning
14. Question Maker Problem Definition
Management
Prevention
Communication
Organisation
Professional Values
Personal Development
15. Situation Problems Advantages
Disadvantages Applied to:
Doctor
Patient
Practice
PHC Team
Relatives
Community
Healthcare
General Public
16. Clinical Problems HEIRS
History
Examination
Investigation
Referral
See again? RAPRIO(P)
Reassure
Advice
Prescribe
Refer
Investigate
Observe
(Preventative)
17. Illness Always answer in terms of:
Physical
Psychological
Social
Family/Community
18. Patients request Agree
Disagree
Negotiate
19. Ethical problems Utilitarianism
examines moral dilemmas
seeks to make decisions based on outcomes
applies to large populations
e.g. the greatest good for the greatest number
Deontological
applies to individuals
based on the duties of the doctor and the rights of the patient (and, of course, vice versa)
20. Ethical solutions ABCDE
Autonomy (Patient)
Beneficence
above all, do no harm
do good where possible
Confidentiality
Do not lie (Truthfulness)
Everybody else (Society)
21. Doctors feelings Awareness
Power
Anger
Guilt
Stress
Conflicts
22. Breaking Bad News A KISS
Anxiety:
try to elicit anxieties
Knowledge:
try to elicit knowledge
Information:
give information simply re treatment, prognosis, follow up
Sympathy:
give human contact (touch)
Support:
give practical help
23. Dealing with Anger AFVER
Avoid Confrontation
Facilitate Discussion
Ventilate Feelings
Explore Reasons
Refer/Investigate
24. Marking Schedules Model answer
Areas of Competence
Word Mapping
25. Areas of Competence Problem Definition
Management
Prevention
Practice Organisation
Communication
Professional Values
Personal/Professional Development